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Dr. Richard Madonna on HTN and why it is a risk factor for glaucoma

Discussion in 'ODwire.org TV & Radio' started by AdminWolf, May 10, 2019.

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  1. #1 May 10, 2019
    AdminWolf

    AdminWolf Site Administrator & Tech Lead
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    In this InSight Studio interview from SECO2019, we speak with Dr. Richard Madonna from SUNY Optometry, where he explains why hypertension is a risk factor for glaucoma. (surprisingly, the answer has part to do with hypotension!
     
  2. #2 May 10, 2019
    AdminWolf

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    Thanks again for Dr. Madonna for sitting down with us.

    I appreciated his "tips" on modifying when the patients take their HTN meds to reduce the risk. The big question is can you get a cardiologist (or GP for that matter) to agree to adjust the patient's dosing schedule?
     
  3. #3 May 10, 2019
    AdminWolf

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    BTW, Dr. Madonna also has a course at CEwire2019 about systemic disease & optometry, if you haven't seen it yet, here's an excerpt:



    You can watch the full show from now until July 1st at CEwire2019!

    -- ad
     
  4. #4 May 10, 2019
    Lloyd Pate

    Lloyd Pate Well-Known Member

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    If you write a letter or call them with your concerns, I have found that they will do it.
     
  5. #5 May 10, 2019
    Ken Elder

    Ken Elder ODwire.org Supporting Member

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    New patient comes to your office. 55wm. He’s being treated for hypertension and reports it’s controlled well. BP in office is 120/80.

    Cd is 0.3 OU.

    Is this patient a glaucoma suspect?

    If so....what tests do you order?
     
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  6. #6 May 10, 2019
    Lloyd Pate

    Lloyd Pate Well-Known Member

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    You have not told us enough to decide. What are the rim ratios? VDD? IOPs?

    However, I tell my students there are two types of patients: glaucoma suspects, and glaucoma patients.
     
  7. #7 May 10, 2019
    Ken Elder

    Ken Elder ODwire.org Supporting Member

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    Let's assume it's all "normal."

    The question is.....is a patient with controlled hypertension a glaucoma suspect? If so, what tests, if any should be ordered?
     
  8. #8 May 10, 2019
    Lloyd Pate

    Lloyd Pate Well-Known Member

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    Yes they are a suspect, all patients are. But there level of suspicion is low. I don't think you can medically justify any glaucoma testing unless you notice a change or have something suspicious. If I did any testing it would be an OCT of the GCC and RNFL.
     
  9. #9 May 10, 2019
    Richard Pagan

    Richard Pagan ODwire.org Supporting Member

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    no, and that is not what the op was alluding to at all
     
  10. #10 May 10, 2019
    Richard Pagan

    Richard Pagan ODwire.org Supporting Member

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    again...no, not what is being discussed here
     
  11. #11 May 10, 2019
    Richard Pagan

    Richard Pagan ODwire.org Supporting Member

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    SOP for many glaucoma cases is to limit the use of BP meds before bedtime, especially bblockers.
     
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